Courtney Anderson, OTR/L

Key facts

NPI

1346067386

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Occupational Therapist 225XP0200X

License

056.016382 (IL)

Practice address

1749 S Randall Rd Ste a
Geneva, IL 60134-4616

Phone

(815) 469-1500

NPI assigned

Sep 23, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 30, 2026.

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1346067386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR STE 304",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488399",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 S RANDALL RD STE A",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344616",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N2270 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Walworth",
            "state": "WI",
            "postal_code": "531845633",
            "country_code": "US",
            "telephone_number": "844-570-5714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "COURTNEY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8640-26",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.016382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

• Sofia Anastasopoulos
• Heather Anaya, DO
• Sissay Z Anberber, MD
• Anchor Counseling Inc.
• Hediyeh Andalib-Jortani, OD
• Kristin Marie Anderson, PH.D., LCP
• Michelle Lee Anderson, LMT
• Theresia M Anderson, CRNA
• Treva B Anderson, PH.D.
• Zachary Taylor Andor, PA-C

All providers in Geneva, IL · Pediatric Occupational Therapist in Illinois